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Frontal Sinus Fractures: Evidence and Clinical Reflections
Christopher D Lopez1, Ricardo Rodriguez Colon2, Joseph Lopez1
1Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.
Management of frontal sinus fractures lacks a clear algorithm. While overall complication rates are similar across treatments, injuries to the nasofrontal outflow tract significantly increase complications.
Area of Science:
- Craniomaxillofacial surgery
- Trauma surgery
- Otolaryngology
Background:
- Frontal sinus fractures present management challenges.
- Limited large-cohort data exists for these injuries.
- A comprehensive literature synthesis is needed.
Purpose of the Study:
- To provide an evidence-based overview of frontal sinus fracture management.
- To analyze outcomes associated with different management strategies.
- To identify factors influencing complication rates.
Main Methods:
- Conducted a comprehensive literature search of PubMed and MEDLINE (1992-2020).
- Included studies investigating frontal sinus fractures.
- Extracted data on fracture type, intervention, and outcomes.
Main Results:
- Analyzed 53 studies out of 456 identified articles.
- No significant differences found in injury mechanism, fracture pattern, management, or overall complication rates.
- Nasofrontal outflow tract injury was associated with a statistically significant increase in complication rates.
Conclusions:
- Frontal sinus fracture management remains complex with no universal algorithm.
- Thorough clinical assessment of fracture patterns and associated injuries is crucial for decision-making.
- Identifying nasofrontal outflow tract involvement is critical for risk stratification.
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